Deck 12: Infections

Question 1

Which of the following is not an associated radiological finding in tuberculosis infection?

A) Gibbous formation
B) Paraspinal cold abscess
C) Ivory vertebra
D) Scalloping of the vertebral bodies due to subligamentous spread

Answer 1

Ivory vertebra

Question 2

Which of the following is not part of Phemister triad?

A) Geographic region of osteopenia surrounded by a rim of sclerosis
B) Juxtaarticular osteoporosis
C) Peripherally located osseous erosions
D) Gradually narrowing joint space

Answer 2

Geographic region of osteopenia surrounded by a rim of sclerosis

Question 3

The imaging modality that is the least useful in detecting early stages of coccidioidomycosis infection of bone is __________.

A) MRI
B) Plain film
C) CT
D) Bone scan

Answer 3

Plain film

Question 4

What is the most common fungal infection worldwide?

A) Blastomycosis
B) Coccidioidomycosis
C) Tuberculosis
D) Maduromycosis

Question 5

Osteomyelitis associated with which of the following infectious organisms often leads to amputation of the involved limb?

A) Blastomycosis
B) Coccidioidomycosis
C) Syphilis
D) Maduromycosis

Question 6

Which of the following is one of the earliest clinical findings in maduromycosis?

A) Painless soft tissue swelling
B) Pathologic fracture
C) Gumma formation
D) Chancre formation

Question 7

Which of the following is an infection that may skip a vertebral level when spreading along the spine?

A) Syphilis
B) Coccidioidomycosis
C) Blastomycosis
D) Maduromycosis

Question 8

What is another name for coccidioidomycosis?

A) Gilchrist disease
B) Valley fever
C) Cystic osteomyelitis
D) Gaucher disease

Question 9

Where is blastomycosis endemic?

A) The Great Lakes regions
B) San Joaquin Valley
C) Mexico
D) Central and South America

Question 10

Which of the following is not a radiographic finding in late congenital syphilis?

A) Saber shin deformity
B) Localized osteopenia
C) Clutton joints
D) Hutchinson teeth

Question 11

Which of the following is not generally assumed to be a risk factor for developing coccidioidomycosis?

A) People older than 65
B) Coal miners
C) Immunocompromised populations
D) Individuals being treated with steroids or chemotherapy

Question 12

Which of the following is not one of the three stages of syphilis?

A) Chancre formation
B) Soft tissue swelling
C) Systemic spread
D) Gumma formation

Question 13

Which of the following is a possible radiographic finding in a patient with blastomycosis infection?

A) Geographic osteolytic destruction
B) Significant periosteal reaction
C) Saber shin deformity
D) Ankylosis

Question 14

Which of the following diseases is caused by Treponema pertenue?

A) Syphilis
B) Tuberculosis
C) Septic arthritis
D) Yaws

Question 15

Blastomycosis is also known as __________.

A) valley fever
B) desert rheumatism
C) Gilchrist disease
D) cystic osteomyelitis

Question 16

The typical sources of maduromycosis infection are soil and __________.

A) water
B) sand
C) thorns
D) coal mines

Question 17

Destructive metaphysitis along the medial margin of the proximal tibia describes __________.

A) bite sign
B) Wimberger sign
C) crescent sign
D) saber shin deformity

Question 18

What is the most accurate method of diagnosing blastomycosis?

A) Skin test
B) Radiographic localization, biopsy, and culture
C) Bone scan
D) MRI

Question 19

Where is coccidioidomycosis endemic in the United States?

A) Northwestern
B) Southeastern
C) Southwestern
D) Northeastern

Question 20

Which of the following infectious organisms causes syphilis?

A) Treponema pertenue
B) Treponema pallidum
C) Mycobacterium bovis
D) Mycobacterium africanum

Question 21

The most remarkable clinical feature of tuberculosis is __________.

A) as the disease progresses, pulmonary complaints decrease
B) treatment only lasts 2 to 4 weeks
C) it causes back pain in 95% of infected patients
D) it lacks symptoms

Question 22

In osteomyelitis, what are pockets of dead bone called?

A) Sequestra
B) Cloaca
C) Involucrum
D) Gumma

Question 23

Clinical presentation of persistent pain in a young person, which often worsens at night and is dramatically relieved by aspirin, may be seen in patients with Brodie abscess and __________.

A) leukemia
B) osteoid osteoma
C) metastasis
D) congenital syphilis

Question 24

Which of the following diagnostic imaging modalities can be used to confidently distinguish a Brodie abscess from an osteoid osteoma?

A) Plain film radiography
B) MRI
C) Angiography
D) Ultrasound

Question 25

In most cases, skeletal involvement with tuberculosis is secondary to hematogenous spread of infection from __________ origin.

A) pulmonary
B) gastrointestinal
C) intravenous drug use
D) viral

Question 26

A 21-year-old male patient presents with knee pain, swelling, and restricted ranges of motion for 3 weeks following trauma. The patient has a mild fever. Radiographs of the knee show distention of the joint capsule, soft-tissue swelling, and osteopenia as well as early joint space narrowing. Which of the following is most likely to be discovered on aspiration of the joint?

A) Aseptic synovial fluid
B) Staphylococcus
C) Streptococcus
D) Pseudomonas

Question 27

What is the most common complaint in a patient with a Brodie abscess?

A) A productive cough
B) Chills, fever, and malaise
C) Persistent pain that often worsens at night
D) Soft tissue swelling

Question 28

The most common radiographic finding in patients with congenital syphilis infection is __________.

A) lucent metaphyseal bands
B) periostitis
C) moth eaten bone destruction
D) periarticular osteopenia

Question 29

Squamous cell carcinoma at the site of cloaca and sinus tract formation from osteomyelitis is known as __________.

A) Garre osteomyelitis
B) involucrum
C) gibbous formation
D) Marjolin ulcer

Question 30

Plain film radiographic evidence of a Brodie abscess consists of __________.

A) a geographic region of osteopenia surrounded by a rim of sclerosis
B) horizontal radiolucent metaphyseal bands
C) destructive metaphysitis along the medial margin of the proximal tibia
D) a sequestrum and involucrum

Question 31

In patients with congenital syphilis, the proliferative changes that result from chronic periostitis along the anterior surface of the tibia produce bilateral anterior tibial bowing known as __________ shin deformity.

A) sickle
B) scimitar
C) boomerang
D) saber

Question 32

A channel through the involucrum that may connect to a sinus and allow migration of pus and bloody bone debris onto the skin surface describes a __________.

A) Cloaca
B) Sequestra
C) Gibbous formation
D) Gumma

Question 33

Which part of the body is typically involved in maduromycosis infection?

A) Hands
B) Feet
C) Spine
D) Sacroiliac joints

Question 34

Which of the following is the most likely route spread of Blastomyces dermatitidis to the skin and bones of an infected patient?

A) Inhalation
B) Direct implantation
C) Hematogenous
D) Contiguous spread

Question 35

Which of the following regions is most commonly affected in patients with disseminated tuberculosis osteomyelitis involving the skeleton?

A) Shoulder
B) Hip
C) Knee
D) Spine

Question 36

Radiographic findings of acquired syphilis are observed in the __________ stage of the disease.

A) primary
B) secondary
C) tertiary
D) quaternary

Question 37

What is the most common causative agent of osteomyelitis?

A) Treponema pallidum
B) Staphylococcus aureus
C) Mycobacterium bovis
D) Streptococcus pyogenes

Question 38

The most common overall causative agent in septic arthritis is __________.

A) Treponema pallidum
B) Mycobacterium bovis
C) Streptococcus pyogenes
D) Staphylococcus aureus

Question 39

Angular kyphosis in the thoracic or thoracolumbar spine that is secondary to tuberculosis osteomyelitis is known as __________.

A) bullet vertebra
B) Gibbous deformity
C) Clutton joint
D) Pott spine

Question 40

The most common infectious organism causing a Brodie abscess is __________.

A) Mycobacterium
B) Staphylococcus
C) Blastomyces
D) Treponema